The percentage of deaths in the State hospitals caused by the principal diseases vary little from year to year. In 1914 and 1913, tuberculosis of the lungs caused 11.7 per cent of the deaths; in 1912; 11.6 per cent; and in 1911, 12.8 per cent. In 1914 general paralysis caused 16.6 per cent of the deaths; in 1913, 16.8 per cent; in 1912, 18.3 per cent; and in 1911, 17.2 per cent. A similar correspondence is seen in the percentages of death caused by the other principal diseases.

Table 33 also shows the causes of the death of patients classified according to the principal psychoses.

In general paralysis the mental disease is usually directly or indirectly the cause of death. Likewise in cases of epileptic insanity, death is principally caused by epilepsy.

The principal diseases causing deaths in some of the other psychoses are as follows:

Causes of death of patients with certain psychoses

Pulmonary tuberculosis each year causes a remarkably large number of deaths among dementia praecox patients.

In the following table is given a comparison of the death rates per 100,000 on account of certain diseases, of the insane in the State hospitals in 1914 and 1913, and those of the general popu

lation of the State for 1913. The rates of the general population for 1914 could not be obtained at the time of preparation of this report.

Comparison of the death rates per 100,000 of the insane and of the general population, 1914 and 1913

The death rate of the insane is nearly five times as great as that of the general population. The difference in rate due to certain diseases is remarkably large; e. g., the death rate from tuberculosis of the lungs among the insane is six times as great

*Total under treatment, exclusive of transfers.

as that among the general population, and from bronchopneumonia nine to twelve times as great. The death rate from violence is less among the insane than among the general population.

The death rates per 1,000 patients under treatment in each of the state hospitals in 1914 and 1913 are set forth in the following table:

The general death rate per 1,000 under treatment was 74.2. Middletown has the lowest death rate and Long Island the highest. The unusually high death rate in the latter hospital is largely due to the admission of sick and infirm patients from the borough of Brooklyn; the healthier patients from the city are sent to Kings Park, which consequently has the lowest death rate of any of the metropolitan hospitals. Why there should be such large differences in the death rate in the up-State hospitals is not known.

RESIDENCE OF PATIENTS BY COUNTIES

Table 34. Residence by counties of first admissions and of patients remaining September 30, 1914, page 701.

Table 34 shows the distribution by counties of first admissions and patients remaining in the hospitals with the rate of each per 100,000 of the general population. The average rate of first admissions for the whole State was 63.3 per 100,000 in 1914 as compared with 62.4 in 1913 and 59.9 in 1912.

The following are the marked variations from the general averages of the past two years:

Counties with a high rate of first admissions, 1914 and 1913

Counties with a low rate of first admissions, 1914 and 1913

It is probable that some of the patients credited to New York should have been credited to Bronx.